Umeno Y, Kogawa K, Matsuishi E, Miyamoto Y, Torii Y, Irie K, Kanda M, Ohshima K
Department of Internal Medicine, Saga Prefectural Hospital.
Fukuoka Igaku Zasshi. 2000 Feb;91(2):55-61.
A 69-year-old man with a diagnosis of multiple IgG class myeloma received combination chemotherapy. He achieved a partial response with an undetected M spike. However, he demonstrated new lytic bone lesions and multiple extramedullary involvement 10 months after the initial presentation. Polymerase chain reaction (PCR) analysis using a framework 3 (Fr3) V-region primer clarified a discrete band in the extramedullary tumor, while it yielded 4 bands including the same size as the extramedullary tumor produced in the bone marrow sample obtained before the chemotherapy. These findings suggest that a resistant and non-secretory clone was selected by the combination chemotherapy.
一名诊断为多发性IgG型骨髓瘤的69岁男性接受了联合化疗。他获得了部分缓解，M蛋白峰未被检测到。然而，在初次就诊10个月后，他出现了新的溶骨性骨病变和多处髓外受累。使用框架3（Fr3）V区引物进行的聚合酶链反应（PCR）分析在髓外肿瘤中明确了一条离散条带，而在化疗前获得的骨髓样本中产生了4条带，包括与髓外肿瘤相同大小的条带。这些发现表明联合化疗选择了一个耐药且非分泌性的克隆。
